June 2014 ICD-10 Open Line Friday

We're pleased to present Rhonda Buckholtz, VP of ICD-10 Education and Training for the American Association of Professional Coders (AAPC), as our June Open Line Friday guest. Rhonda will explain the
…

We're pleased to present Rhonda Buckholtz, VP of ICD-10 Education and Training for the American Association of Professional Coders (AAPC), as our June Open Line Friday guest. Rhonda will explain the approach the AAPC has taken with the delay of ICD-10 to 2015. Visit http://www.bcbsfl.com/wps/portal/bcbsfl/w/providers/providerdetails/SA_ToolsResources/SA_ICD10 for your comprehensive list of ICD-10 resources.

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Open Line Friday: ICD-10
June 20, 2014
Special Guest
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Rhonda Buckholtz
CPC, CPMA, CPC-I, CENTC, CGSC, COBGC, CPEDC
Vice President
ICD-10 Education & Training
Note: Practitioner guests are subject to unforeseen clinical or other emergencies. Should guest(s) become unavailable at the time of our
program, Florida Blue will attempt to reschedule guest(s) for a future session.

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Objectives
1. Promote collaboration, communication and coordination between providers, payers
and electronic trading partners.
2. Expand your understanding of the current state of ICD-10, recent regulatory
decisions and industry perspectives.
3. Raise your awareness and understanding of the unique opportunities and challenges
that ICD-10 brings to the entire health care industry including providers, payers and
electronic trading partners.
4. Provide you with tools, techniques, best practices and helpful hints from your peers
that can be used as you continue (or begin) your ICD-10 journey.
**** Please remember that during the call all attendees will be placed on “mute”
except for any guest speakers and all panelists. If you have a question, please
email it to FloridaBlueOpenLineFriday@FloridaBlue.com.
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Open Line Friday: ICD-10

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Open Line Friday: ICD-10
Health Care Industry & Regulatory Update
• HHS expects to release interim final rule in near future with a new compliance date
requiring the use of ICD-10 beginning Oct. 1, 2015. The rule will also require HIPAA
covered entities to continue to use ICD-9-CM through Sept. 30, 2015.
• American Health Information Management Association (AHIMA) is recommending the
industry “keep its momentum going, continuing to prepare by strengthening clinical
documentation improvement programs, working with vendors on transition readiness,
training coders and other stakeholders, and proceeding with dual coding.”
• CMS ICD-10 Acknowledgement Testing: Providers, suppliers, billing companies, and
clearinghouses may submit acknowledgement test claims with CMS anytime up to the
anticipated Oct. 1, 2015 implementation date. Submitters should contact their local
Medicare Administrative Contractor (MAC) for more information about acknowledgment
testing. However, those who submit claims may want to delay acknowledgement testing
until after Oct. 6, 2014, when Medicare updates its systems.
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Open Line Friday: ICD-10
Health Care Industry & Regulatory Update
• CMS/Medicare ICD-10 Acknowledgement Testing Results from March 2014 were reported
as follows:
• Approximately5% of all submitters (2600) joined in the testing week.
• Over 127k ICD-10 coded claims were sent to the Medicare FFS claims systems
and received a “functional acknowledgement”.
• Nationally CMS accepted 89% of test claims and some regions reported success
rate of 99%; CMS’s normal acceptance rates range from 95% to 98%.
• All claims were required to have:
• A valid NPI and a valid diagnosis code that must match the date of service.
• Claims using ICD-9 or ICD-10 codes had to have a corresponding ICD-10
code qualifier.
• CMS has announced that they will be conducting end-to-end testing in 2015 with details
and schedules to be released “soon”.
• Several organizations are continuing their ICD-10 testing efforts. Are you?
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Open Line Friday: ICD-10
Health Care Industry & Regulatory Update (continued)
• NUCC changes to the CMS 1500 professional paper claim form to accommodate ICD-10
(www.nucc.org); the following recommended transition timeline has applied:
• January 6, 2014: Payers begin receiving and processing paper claims submitted on the
revised 1500 Claim Form (version 02/12).
• January 6 through March 31, 2014: Dual use period during which payers continue to receive
and process paper claims submitted on the old 1500 Claim Form (version 08/05).
• April 1, 2014: Payers receive and process paper claims submitted only on the revised 1500
Claim Form (version 02/12).
• Partial code freeze continues until one year after the implementation of ICD-10:
• Only codes for new diagnosis and new technologies will be considered for exception inclusion.
• Last regular updates to ICD-9-CM and ICD-10 occurred on October 1, 2011.
• Regular ICD-10 updates will begin on October 1, 2016 pending the approval of the October 1,
2015 ICD-10 implementation date.
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Florida Blue Update:
• Florida Blue is deploying a full remediation strategy to implement ICD-10.
• Florida Blue’s ICD-10 initiative is proceeding on plan. We are in the process of
completing our internal Compliance Level 1 testing and are fully engaged in
Compliance Level 2 testing with physicians, providers and external entities.
• Open Line Friday ICD-10 Edition teleconferences will continue every 3rd Friday
of each month. Audio podcast recordings are available through the Podcast link
located at www.floridablue.com/icd-10.
• ICD-10 Testing with Providers: we are continuing to engage providers in Phase I
and Phase II Testing. Phase III is in beta-test mode and will be generally available
in the late May timeframe; details of our provider testing, including a self-service
option, are available at www.floridablue.com/icd-10.
• Florida Blue’s ICD-10 Provider Toolkit will be maintained going forward and is
accessible from www.floridablue.com/icd-10.
• Attention Small to Medium sized providers: “Build your action plan and start
your transition to ICD-10 now with the CMS “Road to 10” tool. It’s simple. Visit the
www.roadto10.org”
Open Line Friday: ICD-10
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Rhonda Buckholtz
CPC, CPMA, CPC-I, CENTC, CGSC, COBGC, CPEDC
Vice President
ICD-10 Education & Training
American Association of Professional Coders
Open Line Friday: ICD-10
AAPC’s ICD-10 Delay Approach
Please refer to our guest speaker’s program material if available which can be accessed at
www.floridablue.com/ICD-10 under Open-Line Friday located in right margin.

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ICD-10
The most effective
way to do it,
is to do it!
– Amelia Earhart

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Next Steps
Next Steps
Build your ICD-10 action plan now with the CMS “Road to 10” tool. Visit www.roadto10.org
Access our Open Line Friday podcasts at www.floridablue.com/icd-10
ICD-10 Open Line Friday email list: send us your email by contacting us at
floridablueopenlinefriday@floridablue.com
Test ICD-10 with us. Visit www.floridablue.com/icd-10 and select our “Test ICD-10 icon”
for details. Testing questions? Email us at ICD-10Testing@floridablue.com
Access Florida Blue’s ICD-10 Provider Toolkit and more at www.floridablue.com/ICD-10
Visit the Availity Learning Center (www.availity.com/learningcenter) to access live and webinars
including information about Ready10 - a popular ICD-10 project management tool (see “There’s
Ready and There’s Ready10”).
Add, update or delete your email and contact information at any time using Availity's secure website. Log
on to Availity at www.availity.com, select Payer Resources, Florida Blue and Update My Email
Information with Florida Blue then follow the prompts.
Open Line Friday: ICD-10
Follow us on Twitter @FLBlue
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Addendum
Open Line Friday: ICD-10
Rhonda Buckholtz, CPC, CPMA, CPC-I, CENTC, CGSC, COBGC, CPEDC
Vice President of ICD-10 Education and Training, AAPC
Rhonda Buckholtz has more than 20 years of experience in healthcare, working in the
reimbursement, billing, and coding sectors, in addition to being an instructor. She is
responsible for all ICD-10 training and curriculum at AAPC. She has authored many
articles for health care publications and has spoken at conferences across the country.
She is co-chair for the WEDI ICD-10 Implementation Workgroup and has provided
testimony ongoing for ICD-10 and standardization of data for NCVHS. She also sits on
the Provider Outreach and Education committee for Novitas Solutions (formerly Highmark
Medicare Services).